髓性白血病髓外浸润33例FNAC诊断

Diagnosis of extramedullary infiltration of leukemia by fine needle aspiration cytopathology

目的 白血病髓外浸润是针吸细胞病理学 (FNAC)诊断的难点 ,为了提高其诊断准确率。方法 对 33例髓性白血病髓外浸润的临床及FNAC诊断结果进行分析总结。结果 急性髓细胞性白血病 (AML) 2 3例、慢性髓细胞性白血病 (CML) 10例。AML髓外浸润者平均年龄 2 9 7岁 ,以成人为多 ,占 6 9 6 % ;CML髓外浸润者均大于 2 0岁 ,平均 37 5岁。各部位中以淋巴结浸润最多 ,占 78 8%。结论 髓性白血病髓外浸润的FNAC诊断应紧密结合临床及有关实验室检查 ,否则较易误诊 ,特别是以局部肿块为首发症状而就诊的白血病。各类白血病髓外浸润以原始细胞增生为主者 ,均需与非霍奇金淋巴瘤鉴别。

Objective To improve the diagnostic accuracy of the extramedullary infiltration of leukemia, which was a problem in diagnosis by fine needle aspiration cytopathology (FNAC). Methods We analyzed the diagnostic results of FNAC from 33 cases of the extramedullary infiltration of leukemia. Results In the 33 cases, there were 23 cases of acute myelogenous leukemia (AML), and 10 cases of chronic granulocytic leukemia (CML). The average age of the patients with the extramedullary infiltration of AML was 29.7, in which 69.6% were adults. All the patients of the extramedullary infiltration of CML were older than 20, whose average age was 37.5. The most infiltrated site was lymph node, which accounted for 78.8%. Conclusion The pathological diagnosis of extramedullary infiltration of leukemia by FANC should be combined with clinical examination and some related laboratory test. It is easy to confuse some kinds of leukemia, especially in the patients whose initial symptom is local mass. All sorts of leukemia, whose extramedullary infiltration is the proliferation of mainly primitive cells, should be differentiated from non-Hodgkin's lymphoma.